Sarcoidosis of the tongue. Report of a case

[Specific tongue involvement revealing sarcoidosis]

BACKGROUND

Sarcoidosis is a multisystem granulomatous disease of unknown aetiology. Tongue involvement is extremely rare. Herein we report a new case.

PATIENTS AND METHODS

A 65-year-old woman presented with a 6-month history of painless multiple nodules on the tongue. The patient also complained of xerostomia. Besides nodules on the tongue, physical examination revealed erythematous nodules on the dorsum of the hands and feet. A diagnosis of sarcoidosis with tongue, cutaneous and salivary gland involvement was made on the basis of these findings and further investigations performed. The patient's condition showed improvement with partial regression of tongue lesions after oral steroid therapy.

DISCUSSION

Tongue involvement in sarcoidosis is exceedingly rare. It may be isolated or part of a generalized multisystem sarcoidosis. Nodules, indurations and swelling are the most common clinical manifestations. Management of tongue sarcoidosis is not consensual. Oral corticosteroids appear to be the most effective therapy.

CONCLUSION

Sarcoidosis of the tongue should be considered when chronic unexplained nodules are noted. Diagnosis can easily be confirmed by a histological examination of mucosal biopsy.

Sarcoidosis of the tongue: a case report

A case of sarcoidosis involving the tongue is described in a 48-year-old Japanese man. A definite diagnosis of sarcoidosis was made for the clinical lesion and pathological examinations. Sarcoidosis is a multisystem granulomatous disease that may affect any organ. Sarcoidosis of the tongue is particularly rare.

Oral sarcoidosis: a review of literature

Sarcoidosis is a common systemic granulomatous disease affecting multiple organs. Oral involvement is relatively rare and, to our knowledge, there have been only 64 cases reported in the English literature. Most cases of oral sarcoidosis present with mobility of the teeth due to rapid alveolar bone loss. Other oral manifestations include asymptomatic swelling of the involved mucosa, gingivitis and ulcers. Diagnosis of sarcoidosis is by exclusion as no specific test is available. Radiographic, biochemical and histological findings are non-specific, but helpful. All cases of sarcoidosis do not require treatment. Corticosteroids are the treatment of choice in patients requiring treatment. Other drugs such as chloroquine, methotrexate, infliximab and thalidomide are also used in the treatment of sarcoidosis. In most of the oral cases reported, systemic steroids and surgery were the preferred treatment.

A case of sarcoidosis involving the tongue

Sarcoidosis is a systemic granulomatous disorder which commonly affects the skin. Involvement of the tongue is rare; a review of the previous literature over the last 30 years revealed only six cases of sarcoidosis affecting the tongue. We studied a case of sarcoidosis involving the tongue in a 32-year-old Japanese woman with characteristic clinical and pathological findings. She visited our department with a complaint of a tongue lesion of which she had been aware for a month. A diagnosis of sarcoidosis was made for the lesion by clinical and pathological examinations. Oral involvement by sarcoidosis is rare, however this disorder should be considered as a possible cause of intraoral granulomatous lesions.

Oral sarcoidosis with tongue involvement

A case of oral sarcoidosis involving the tongue and buccal region is reported in a 56-year-old woman. Intraoral presentations of sarcoidosis are uncommon, and sarcoidosis of the tongue is particularly rare. In this case the tongue lesion was asymptomatic, and unusual clinical behavior. In this article, we review the clinical manifestations, diagnostic procedures, differential diagnosis and treatments of oral sarcoidosis.

Oral manifestations of sarcoidosis

OBJECTIVE

To report two new cases of sarcoidosis of the buccal mucosa and to analyze the literature on oral manifestations of sarcoidosis.

STUDY DESIGN

Oral lesions with histologic features of sarcoidosis were analyzed according to their location and appearance.

RESULTS

Analysis of 45 cases of oral sarcoidosis (43 from the literature and the 2 new presented cases) revealed 12 lesions in the jaws, 10 in the buccal mucosa, 6 in the gingiva, 5 in the lips, 5 in the floor of the mouth, 4 in the tongue, and 3 in the palate. Sarcoidosis in the jaw was located in the alveolar bone and presented as an ill-defined radiolucency. Submucosal nodules were observed in sarcoidosis affecting the buccal mucosa, palate, and lip. Swelling was the main manifestation in the gingiva. In the floor of the mouth, sarcoidosis presented as ranula and that of the tongue as induration. In most of the cases, the lesions in the buccal mucosa, gingiva, and tongue were the first clinical manifestation of the disease.

CONCLUSION

Oral sarcoidosis lesions should be considered in the differential diagnosis of oral soft tissue swellings and jaw lesions.

Sarcoidosis of the tongue

A 43-year-old man with an 8-month history of swelling of the tongue is described. Biopsy of the tongue revealed numerous epithelioid cell granulomata. A positive Kveim test, elevated angiotensin converting enzyme level and bilateral hilar lymphadenopathy confirmed the diagnosis of sarcoidosis. Sarcoidosis presenting in the tongue is extremely rare.

Sarcoidosis. Report of two cases with oral involvement

Sarcoidosis is a multisystem granulomatous disease in which pulmonary involvement is the most characteristic feature. Even though extrapulmonary manifestations occur infrequently in the area of the head and neck an occasional patient will have oral involvement. As we will demonstrate in these case reports, sarcoidosis should be included in the differential diagnosis of oral and perioral papular lesions noted on examinations of the head and neck.

Sarcoidosis of the tongue--a case report

A case of sarcoidosis, unusual in that it was confined to the tongue, is reported in a 50 year-old female. The condition resolved after 1 year of steroid therapy and excision of fibrous tethering bands. Intra-oral sarcoidosis should be considered in the differential diagnosis of lingual swelling and induration.

Lymphoid lesions of the oral cavity

The lymphoid lesions of the oral cavity may be classified into three groups: 1. Benign lesions. 2. Malignant lesions. 3. Other lymphoid-like lesions. 1. Benign lymphoid lesions: In this group the following lesions must be differentiated: reactive lymph node hyperplasia, enlarged follicle of the lingual tonsil, lymphoepithelial cysts, lymphoepithelial lesions, lymphoid polyps, and cystadenolymphomas. The most frequent locations of benign lymphoid lesions are the lingual tonsil, buccal mucosa, tongue, and floor of mouth. 2. Malignant lesions: One subgroup includes the systemic lymphoid diseases, the other subgroup the lymphoid tumors. According to the WHO classification, the following entities belong to systemic lymphoid diseases: acute and chronic lymphoid leukemia, Waldenström's macroglobulinemia, plasma-cell leukemia, heavy-chain disease, Sézary's disease, and chronic lymphoproliferative diseases (unclassified). WHO has classified the lymphoid tumors as follows: lymphosarcoma, mycosis fungoides, plasmacytoma, reticulosarcoma, unclassified malignant lymphomas, Hodgkin's disease. The WHO classification is compared to the Kiel classification. The special cell types and the differences of the two international classifications are interpreted, especially terms such as centroblastic-centrocytic lymphomas, immunoblastic lymphomas, and the different terminology of reticulosarcomas. 3. Other lymphoid-like lesions: The following examples are discussed in relation to the oral cavity: eosinophilic granuloma, sarcoidosis, Melkersson-Rosenthal's syndrome, Wegener's granulomatosis, foreign body granuloma, and other lesions.